title: Liver steatosis (LS) evaluated through chemical-shift magnetic resonance imaging liver enzymes in morbid obesity; effect of weight loss obtained with intragastric balloon gastric banding.
abstract: The aim of this study was to evaluate in morbid obesity clinical and metabolic effects related to weight loss on liver steatosis (LS), measured through chemical-shift magnetic resonance imaging (MRI) and liver enzymes. Forty obese subjects (8 M/32 W; BMI 42.8 ± 7.12 kg/m(2), mean ± SD) were evaluated for LS through ultrasound (US-LS), chemical-shift MRI (MRI-LS), liver enzymes [aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyltransferase (GGT), alkaline phosphatase (ALP)], anthropometric parameters [weight, BMI, waist circumference (WC)], lipids, insulin, insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), oral glucose tolerance test, and body composition [fat mass (FM) and fat-free mass (FFM) at bio-impedance analysis (BIA)]. Anthropometric measures, MRI-LS, BIA, and biochemical parameters were reevaluated 6 months later in 18 subjects undergoing restrictive bariatric approach, i.e., intragastric balloon (BIB, n = 13) or gastric banding (LAGB, n = 5), and in 13 subjects receiving hypocaloric diet. At baseline, US-LS correlates only with MRI-LS, and the latter correlates with ALT, AST, and GGT. After 6 months, subjects undergoing BIB or LAGB had significant changes of BMI, weight, WC, ALT, AST, GGT, ALP, HbA1c, insulin, HOMA-IR, FM, FFM, and MRI-LS. Diet-treated obese subjects had no significant change of any parameter under study; change of BMI, fat mass, and fat-free mass was significantly greater in LAGB/BIB subjects than in diet-treated subjects. Change of MRI-LS showed a significant correlation with changes in weight, BMI, WC, GGT, ALP, and basal MRI-LS. Significant weight loss after BIB or LAGB is associated with decrease in chemical-shift MRI-LS and with reduction in liver enzymes; chemical-shift MRI and liver enzymes allow monitoring of LS in follow-up studies.
authors.affiliation: Divisione di Medicina Generale II, Dipartimento di Scienze della Salute (DISS) Ospedale San Paolo, Università degli Studi di Milano, via antonio di rudinì 8, 20142, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Folini
authors.forename: Annamaria
authors.initials: A
authors.lastname: Veronelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Benetti
authors.forename: Carlo
authors.initials: C
authors.lastname: Pozzato
authors.forename: Marco
authors.initials: M
authors.lastname: Cappelletti
authors.forename: Enzo
authors.initials: E
authors.lastname: Masci
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Micheletto
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Pontiroli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D050110:Bariatric Surgery / Q000295:instrumentation; D005234:Fatty Liver / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000201:enzymology / Q000209:etiology; D005260:Female; D015905:Gastric Balloon; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008099:Liver / Q000098:blood supply* / Q000201:enzymology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000378:metabolism
chemical_list: D007328:Insulin; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase